*Pluralism Medical Treatment, Prevention, and Control of COVID-19 Infection… DOI: http://dx.doi.org/10.5772/intechopen.106339*


*P: poster presentation; and AC: academic conference.*

#### **Table 2.**

*Summary of project related to the older populations and Medical Pluralism (MP) from MSU, CPRU, and KKU staffs' presentation during 2018-2022.*

expected criteria. It was found that the mean score of the students' knowledge at posttest (x = 9.00) was higher than those at pre-test (x = 6.00), with a significant level of p < 0.001. Moreover, the score of satisfaction toward the CAI was high on every item. The computer-assisted instruction results in the student's acquiring knowledge on nursing care of gerontological nursing [22].

#### *Pluralism Medical Treatment, Prevention, and Control of COVID-19 Infection… DOI: http://dx.doi.org/10.5772/intechopen.106339*

For giving knowledge of COVID-19 infected during the pandemic in 2019–2022, Chaiyaphum Rajabhat University (CPRU) had organized two academic conferences to educate professional nurses about the prevention and control of people and people infected with COVID-19 in terms of both policy and practice. Those professional nurses were provided with knowledge and understanding of situations and trends for the COVID-19 management. At the conference, the Director-General of the Department of Medical Sciences gave a talk on treating and caring for COVID-19 patients by medical professionals, effects and infection control in Asian countries including Japan and Indonesia, management for nurses in hospitals, roles of professional nurses in hospitals and communities, and application of nursing theories and processes. The conference was continually organized as the second meeting to develop nursing leadership potential in the situation of COVID-19. This second conference covered services, administration, research, and nursing education. The conference was paid an honor by the Dean of the Faculty of Nursing at UCLA and was attended by scholars from all the regions of Thailand and professional nurses who work in Thailand and abroad (**Table 2**).

*In step 2:* Reported herbal medicine in pluralism medical treatment, prevention, and control of COVID-19 infection and its long sufferings of Thai people in the Northeast of Thailand.

To promote herbal medicine, the staff of Khon Kaen University (KKU), Mahasarakham University (MSU), and Phon Hospital gave knowledge and practice to the villagers in Khon Kaen province. The results showed that the Community leaders, Health Volunteers (VHVs), and the villagers gain more knowledge and experience of herbal planting for medical use and increase household income (**Table 1**).

The medical practice guidelines, diagnosis, treatment, and prevention of infection in the hospital in case of Coronavirus infection in 2019 (COVID-19) from the Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, the treatment of COVID-19 are as below:

Probable case person with test results positive for Rapid Antigen Test or Antigen Test Kit (ATK per SAR-CoV-2), and total confirmed cases, both those who have symptoms and asymptomatic person separate group according to the severity of the disease and risk factors can be in four cases as follows:

1.Asymptomatic COVID-19


2. Symptomatic COVID-19 without pneumonia, and no risk factors for severe disease.

• May consider giving Favipiravir by starting the drug as soon as possible.

	- Older than 60 years
	- Chronic Obstructive Pulmonary Disease (COPD), includes another Chronic Lung Disease
	- Chronic Kidney Disease (CKD)
	- Cardiovascular disease, including congenital heart disease
	- Cerebrovascular disease
	- Uncontrollable Diabetes
	- Obesity (weight more than 90 Kg, or BMI > 30 Kg/Square meter)
	- Liver Cirrhosis
	- Low immunity, and lymphocytes less than 1000 cells/cubic millimeter, or
	- Patients without risk factors, but tends to the severity of the disease increased

It is recommended to use only one antiviral drug as below, considering congenital disease; contraindications to the drug against each other of antivirus drug, and original medicine (drug-drug interaction), bed management, ease of drug administration, and reserve dose of drugs.


exercising (exercise-induced hypoxemia) or chest radiograph has the progression of pulmonary infiltrates.

	- Patients with mild symptoms but their risk factors for the severe disease, or have major comorbidities or patients with pneumonia, also do not need oxygen.
	- Patients with severe pneumonia no later than 10 days after symptoms, and receive cannula >1 liter/min, and level of SpO2 < 95%, or receive HFNC/NIVHFNC or use a ventilator (if wear a breathing apparatus may benefit from this drug is not fully).
	- Pregnant woman with pneumonia (has more details on the topic of treatment COVID-19 in pregnant women).
	- There are contraindications to the administration of the drug by mouth or absorption problems.

The Department of Thai Traditional and Alternative Medicine presented the restored health after COVID-19 infection with herbal medicine as shown in **Table 3**.

*In step 3:* We reported case success in treatment prevention and control of COVID-19 infected.

Since 2019, the elderly who get COVID-19 received treatment in the hospital and home isolation. The older adults who used medical pluralism (MP) during treatment were our case studies.

We followed the treatment of Coronavirus with the phone who was admitted to the University Hospital of KKU and MSU. Those cases who did not use MP and died from their complication did not report in this study.

We could only review report the number of cases with COVID-19 on May 31, 2022 at the Area Health District, which includes seven provinces in the Northeast of


#### **Table 3.**

*Restore health after COVID-19 Infection with herbal medicine (Available from: https://web.facebook.com/inf ormationcovid19/posts/498540561764273?\_rdc=1&\_rdr).*

Thailand such as Udon Thani, Sakon Nakhon, Nakhon Phanom. Loei, Nong Khai, Nong Bua Lamphu, and Bueng Kan reported cases of COVID-19 as +264 new cases; 123,760 cumulative patients, 21,956 hospitalized, and 120,195 healed [23].

Our cases reported from 2019 to 2022 are divided into four groups as follows:


#### **4.1 Case of unable to COVID vaccination**

One Thai male, age 64 years old who cannot vaccinate COVID vaccine since 2019, because he has health problems of chronic illness and heart diseases. He needs to insert three catheters entering the heart and used much medicine to protect against embolism. His life is very difficult during the COVID-19 pandemic in Thailand.

He changes his lifestyle by quitting smoking, taking medicine and food as prescribed by the doctor, taking some supplements and herbs, exercising according to the doctor's orders, living in a well-ventilated environment, getting enough rest, and following Thai policies to prevent COVID-19 infection. He insisted that pluralism of medical treatment prevention and control of COVID-19 infection was very good for him.

*Pluralism Medical Treatment, Prevention, and Control of COVID-19 Infection… DOI: http://dx.doi.org/10.5772/intechopen.106339*

#### **4.2 Case of COVID-19 infected**

One Thai female, age 70 years old who had controllable diabetes mellitus, got COVID-19 infected with test results positive for Rapid Antigen Test. She was asymptomatic COVID-19 and received Andrographis Paniculate for treatment and home isolation. She takes this medicine and food as prescribed by the doctor, exercises according to the doctor's order, lives in a well-ventilated environment, and gets enough rest.

Nowadays, she takes some supplements and herbs, also has health practices as above, and follows Thai policies to prevent long Covid-19 suffering.

#### **4.3 Case of COVID-19 infection and its long sufferings**

One Thai female, age 59 years old, got COVID-19 infected in 2021 with symptomatic COVID-19 without pneumonia and no risk factors for severe disease. Her doctor gave Favipiravir by starting the drug as soon as possible. But she needs to work hard and not get enough rest.

At present, she still has a persistent cough. She uses cough medicine, namely Makhampom for cough relief, takes some supplement and herbs, and follows Thai policies to prevent COVID-19 infected to other people nearby.

#### **Figure 1.**

*Summarized the organization chart related to pluralism medical treatment in Northeastern,Thailand, since 2019.*

### **4.4 Case of the older adults' health-seeking behavior in the Northeast of Thailand during COVID-19 Outbreaks**

One Thai female, age 60 years old, she fell in the bathroom and ruptured blood vessels in the brain that paralyzed her. Her husband is famous for Thai traditional treatment, but her daughter believes in treatment with modern medicine because she works in one private hospital in Khon Kaen province. During the COVID-19 outbreak in Thailand, patients have difficulty going to the hospital.

Her family members always quarreled about treatment. One female health volunteer in this village recommended her family and other patients to the treatment of Thai traditional medicine and modern medicine. After that, this older adult with hemiplegia gradually got better, and her family is happy.

*In step 4:* We summarized the organization chart related to pluralism medical treatment in Northeastern, Thailand, since 2019.

Medical pluralism (MP) plays a role in many people's lives over the world. Older people in the Northeast of Thailand are familiar with the herb, Thai government policies have implemented pluralism medicine for treatment, prevention, and control of COVID-19 infected Thai people as summarized by the organization as present in **Figure 1**.

#### **5. Discussions**

Medical pluralism (MP) is used in many countries over the world during the COVID-19 outbreak. Our review articles found that pluralism in medical treatment, prevention, and control of COVID-19 infection and its long sufferings was found in most older adults worldwide, it presented that most countries have medical pluralism (MP) for care sickness of the populations [24].

The government of Thailand focuses on the older adults and classified them as a risk group, by giving it the name 608 groups (groups of people who need to get vaccinated with the most COVID are older people aged 60 years and over and those with underlying disease, including chronic respiratory disease, cardiovascular disease, chronic renal disease, cerebrovascular disease, obesity, cancer, and diabetes) that will be vaccinated in the first priority group. Similar to other countries, which are the aging society, they also focus on the older populations, they arranged at least three vaccinations of COVID-19 vaccine for those older adults [25].

Most Thai older adults are familiar with herbs because it's grown for food and medicine [9, 11]. During the COVID-19 outbreak in 2019, Thai older people in rural communities used herbs, such as Andrographis paniculate to build immunity for preventing COVID-19 infection [26]. Similar to other studies presented, herbal medicine is a class of natural substances and is also used as adjuvant therapy for COVID-19. These herbal medicines are psoralidine, silverstrol, quwrrectin, myricellin, flavonoids, and polyphenols [27–29].

Health interventions have been implemented, reducing the rate of the COVID-19 infection, including a face mask, hand hygiene, COVID vaccination, home isolation, and social distancing, similar to the prior studies [30, 31].

Our review of research, and projects produced at Mahasarakham University (MSU), Chaiyaphum Rajabhat University (CPRU), and Khon Kaen University (KKU) presented that Modern Biomedicine and Thai Traditional Medicine can help reduce the severity of the infection and long sufferings of the COVID-19 during 2019–2022, among the older adults in the Northeast of Thailand.

*Pluralism Medical Treatment, Prevention, and Control of COVID-19 Infection… DOI: http://dx.doi.org/10.5772/intechopen.106339*

#### **6. Conclusion**

The medical pluralism (MP) between modern biomedicine and Thai traditional medicine is needed to remedy COVID-19 cases among the older adults because most of them are familiar with herbs used in their household for food and medicine.

The promotion of herbal planting for medical use, which is increasing household income for the villagers in the Northeast of Thailand, should be widely developed and safe for all people in Thailand.

#### **Acknowledgements**

The authors thank (a) all the respondents for their valuable contribution to this study, (b) The Faculty of Medicine of Mahasarakham University and Khon Kaen University for data and financial support, (c) The Faculty of Nursing of Chaiyaphum Rajabhat University for data and financial support, and (d) Dr. Thawalsak Ratanasiri, Dr. Bangonsri Jindawong, Dr. Chanchanok Aramrat, and Mrs. Sompong Chantakram for help search.

### **Conflict of interest**

All authors declare that they have no conflicts of interest.
